Melbourne School of Population and Global Health - Research Publications
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ItemCommunity development interventions to improve Aboriginal health: Building an evidence base(Informa UK Limited, 2007-10)
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ItemDeep structure and controversy: Re-reading the fluoridation debate(ECONTENT MANAGEMENT, 2009-10)
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ItemSilent witnesses: Child health and well-being in England and Australia and the health transition 1870-1940(ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2009-06)
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ItemWalking: A gender issue?(WILEY, 2008-01-01)Gender has been neglected in models of the social determinants of health. We use walking as a case study to demonstrate how gender might be incorporated into multilevel social determinants of health frameworks to investigate health behaviours. We found that while men and women had some similar individual (e.g. confidence in doing regular physical activity) and environmental (e.g. presence of destinations) predictors of walking there were also gender differences in the associations found at both of these levels. For example, low levels of education were only associated with men's walking time while having people in the household who made walking easy or hard was only associated with women's walking time. Likewise, having a variety of places to walk to was important for women's walking but not men's. These results indicate that both universal and gender‐specific approaches to health education, health promotion and planning might be needed to improve walking levels.
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ItemGender equity and women's contraception use(WILEY, 2008-01-01)Gender equity describes the distribution between men and women of social and material resources and decision‐making powers. Women's experiences of gender equity are likely to influence their contraceptive use. Multilevel analysis of two databases: the National Survey of Sexual Attitudes and Lifestyles from the United Kingdom and the United Nations' Fertility and Family Surveys, was undertaken to explore the association between gender equity measured at two spatial scales (small areas and countries) and women's contraception use. Results suggest that the spatial scale at which gender equity is considered is important. Gender equity was associated with contraception use at a local level, but not at the country level. Further, gender equity (at a local level) benefited women with less education in terms of increasing their likelihood of contraception use compared with more highly educated women. Results suggest gender equity is a potential pathway to reducing socio‐economic inequalities in health in developed settings.
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ItemDiscrimination and health in an English study(PERGAMON-ELSEVIER SCIENCE LTD, 2008-04)In this study we examine the relationship between education, racial discrimination and health among white (n=227), African Caribbean (n=213) and Indian and Pakistani (n=233) adults aged between 18 and 59 years living in Leeds, England, as measured in a stratified population survey. Measures of discrimination included any physical attack, verbal abuse and a combined variable, any discrimination due to race, colour, ethnicity or sex. Analyses were conducted examining the relationship between education and discrimination, discrimination and health, and discrimination and health controlling for education. People educated above secondary level were more likely than people educated to secondary level or below to report being physically attacked, verbally abused and exposed to discrimination. People from minority ethnic groups (African Caribbean and Indian Pakistani) were more likely to be verbally abused and exposed to discrimination than the white group. Ethnicity and education interacted for African Caribbeans, such that respondents with post-school qualifications were more likely to report verbal abuse or any discrimination. There was no association between having been exposed to any kind of discrimination and having fair or poor health. Physical attack and any discrimination were associated with anxiety, worry and depression. The results remained unchanged when ethnicity and education were included in the models. Education and ethnicity were associated with differences in exposure to discrimination. In turn, exposure to discrimination was associated with higher levels of anxiety, worry or depression although there was no association between discrimination and health. The results support the contention that racial discrimination may play an important role in modifying the relationship between ethnicity, socioeconomic position and health. The counter-intuitive relationship between education and levels of reported discrimination in non-minority ethnic groups highlights the value of explicitly modeling discrimination to gain a better understanding of the social determinants of health.
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ItemAmbivalent helpers and unhealthy choices: public health practitioners' narratives of Indigenous ill-health(PERGAMON-ELSEVIER SCIENCE LTD, 2005-03)Public health practitioners in Australian indigenous health work in a complex political environment. Public health training is limited in providing them with conceptual tools needed to unpack the postcolonial nexus of 'fourth-world' health. A workshop was designed by the authors to facilitate critical reflection on how the concepts of race and culture are used in constructions of indigenous ill-health. It was attended by researchers, students, clinicians and bureaucrats working in public health in northern Australia. A thematic analysis of the workshop minutes provided insight into public health practitioners' narratives of Indigenous ill-health. The major themes that emerged included tension between structure and agency and between sameness and difference, and ambivalence surrounding the 'helper' identity of public health practitioners. We suggest that these narratives can be understood as attempts to maintain the moral integrity of both Indigenous people and practitioners. This task is necessitated by the specter of cultural relativism intrinsic to contemporary liberal discourses of multiculturalism that attempt to reconcile the universal rights of the citizen with the special rights of minority groups. We argue that the concepts of self-determination and neocolonialism mark the spaces where universal and particular discourses overlap and clash. Practitioners who seek to escape neocolonialism must inhabit only the discursive space of public health congruent with self-determination, leaving them in a bind common to many postcolonial situations. They must relieve the ill-health of indigenous people without acting upon them; change them without declaring that change is required.
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